Artificial Intelligence ‘Invades’ Pathology, Billing

Predictions about the potential of artificial intelligence (AI) to transform nearly every area of healthcare are about to become reality. For the profession of laboratory medicine, AI is making speedy inroads into two areas. The first is anatomic pathology and the second is lab coding/billing/ collections—the revenue cycle management (RCM) functions essential to the financial health of every laboratory organization. 

Using artificial intelligence to analyze whole-slide images of tissue and match the diagnostic accuracy of an experienced subspecialist pathologist has been the Holy Grail of companies working in this field. Now, in Europe and the United States, the first AI-powered solutions that automate digital pathology image analysis for primary diagnosis are obtaining regulatory clearance. First-mover pathology groups are in the earliest stages of incorporating AI into their daily clinical workflows. Our analysis of the US$97 million in investment capital raised by of Australia—that includes funding from Sonic Healthcare—is the latest example of swift progress in advancing AI technologies to the point where they function acceptably in the primary diagnosis of many types of cancer. (See this article.) 

The second area of medical laboratory operations where pathologists and lab administrators can expect to see a multiplicity of AI-powered products is in lab test billing, coding, and collections. There are two reasons for this: One, any contribution AI can make to automate labor-intensive functions in coding, billing, filing appeals, and collecting from patients can reduce RCM costs as well as increase the total amount of revenue collected from the same number of claims. Two, AI in various RCM functions may only need to manage a certain number of variables. For example, confirming a patient’s identity may need only 10 or 15 factors to be checked, assessed, and verified. It is easy to train today’s generation of AI-powered lab RCM tools to work with these factors and develop accurate answers. (See this article.) 

Recognizing the fact that artificial intelligence is about to move into clinical labs and anatomic pathology groups for use in a variety of tasks and functions, our upcoming 27th annual Executive War College on Lab and Pathology Management in New Orleans is scheduling presentations by labs who are pioneering the use of AI in both surgical pathology and revenue cycle management. TDR



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